Sinking streams, and occasional sinkholes, often simply called "sinks," are associated with the cave and karst regions of eastern and southeastern West Virginia. Sinks are points where surface water enters the ground. Sometimes called disappearing or lost rivers, sinking streams eventually return to the surface as springs or "rises." These sinks may form a "blind valley" at the base of a cliff where a surface stream enters a cave, and little or no trace of the stream is left on the land surface beyond the sink point. Many sinks are associated with large cave passages.

Examples of sinking streams include the Sinks of Gandy Creek in Randolph County, Sinks of Hills Creek in Pocahontas County, and the Sinks of Sinking Creek in Greenbrier County. Other sinking streams include Culverson Creek in Greenbrier County and Laurel Creek in Monroe County. Milligan Creek in Greenbrier County rises and sinks several times in its channel before its final rise at Davis Spring. The Lost River in Hardy County, West Virginia's largest sinking stream, sinks completely in its channel during low-flow conditions and rises as the Cacapon River.

The term sinks may also refer to sinkholes or dolines on the surface that do not necessarily capture surface streams. These sinkholes are caused by the slow dissolving of soluble underground rock strata, usually limestone. The community of Sinks Grove in Monroe County derives its name from the numerous deep sinkholes in the area.